- The Washington Times - Tuesday, June 3, 2008

Sen. Edward M. Kennedy underwent successful surgery Monday at Duke University Medical Center for a cancerous brain tumor in what was “just the first step” of his treatment plan, his surgeon said.

“I am pleased to report that Senator Kennedy’s surgery was successful and accomplished our goals,” Dr. Allan Friedman, chief neurosurgeon at Duke University Hospital said after performing the 3 1/2 hour procedure early Monday. “Senator Kennedy was awake during the resection and should therefore experience no permanent neurological effects from the surgery,” Dr. Friedman said.

After the surgery, Mr. Kennedy, 76, told his wife, Vicki, “I feel like a million bucks,” and joked “I think I’ll do that again tomorrow,” an aide to the senator said.

The senator from Massachusetts was diagnosed last month with a malignant glioma on the left side of the brain. In a statement earlier Monday, he said he would undergo surgery at Duke, recuperate there for one week and then begin radiation and chemotherapy at Massachusetts General Hospital.

“I look forward to returning to the United States Senate and to doing everything I can to help elect Barack Obama as our next president,” said Mr. Kennedy, a Democrat who has served in the Senate since 1962.

According to the American Association of Neurological Surgeons (AANS), a surgeon’s goal in an operation such as Mr. Kennedy’s is to remove as much of the tumor as possible without damaging surrounding brain tissue. Dr. Friedman didn’t specify how much of the tumor he was able to remove in Mr. Kennedy’s case.

Surgeons sometimes opt to keep the patient awake during the procedure and track their language function before deciding which portions of the tumor are safe to cut, said Dr. Gail L. Rosseau, a neurosurgeon at the Chicago Institute of Neurosurgery and Neuroresearch and a spokeswoman for AANS. It’s a way to test the tumor’s perimeters, she said.

Dr. Rosseau said surgeons wouldn’t be able to remove all of Mr. Kennedy’s tumor because malignant gliomas have roots. That’s why radiation and chemotherapy are used afterward.

Mr. Kennedy’s tumor is on the left side of his brain, so it has the potential to impair speech and mobility on his right side, she said, noting that after surgery patients may display speech or mobility weakness that disappears as they recover. “If he is weak on his right side [in the hours following surgery] it doesn’t necessarily mean he’ll remain weak on that side,” Dr. Rosseau said.

Researchers at Duke have spent the past few years investigating a cutting-edge vaccine that could potentially double the survival time for patients who have Glioblastoma multiforme (GBM).

Mr. Kennedy’s doctors have only said that his tumor is a malignant glioma. The most deadly type of malignant glioma is a GBM, which is categorized as a stage 4, Dr. Rosseau said.

The latest results of the vaccine trial, conducted by Duke and MD Anderson Cancer Center, were presented Monday at the American Society of Clinical Oncology’s annual meeting.

The vaccine targets a specific protein found in about half of GBM tumors. It enhances the body’s immune response to the protein and kills tumor cells that contain it, said Gary Archer, a Duke researcher on the team who holds a doctorate in neurosurgery. The vaccine, administered in the groin, is given to patients who already had surgery, radiation and chemotherapy.

So far, the vaccine has helped 23 patients survive, tumor-free, for a median of 16 months, more than double the typical six-month period. On average, patients who got the vaccine lived 33 months, compared to the average 14-month survival of GBM patients.

The trial has expanded to 20 sites and more patients nationwide and is now being run by a private company, Mr. Archer said.

If this vaccine continues to succeed, “it will be huge,” he said. “We’re really excited.”

Standard treatment for malignant brain tumors is surgery, followed by radiation and a chemotherapy drug called temozolomide, Mr. Archer and other specialists said.

Several other chemotherapy drugs and new ways of administering them are being investigated, according the American Brain Tumor Association (ABTA).

For instance, sometimes after brain tumor surgery, doctors will opt to pack the wound inside the brain with dime-sized wafers filled with a chemotherapy agent called carmustine, which slowly dissolves and treats remaining tumor cells, according to ABTA.

The American Cancer Society estimates that about 13,070 people in the United States will die of malignant tumors of the brain or spinal cord this year.

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